Warning: cranky indictment of the American medical system, and I’m also not feeling dejoy of the U.S. Postal Service.
Eight days ago, my oxygen concentrator broke. This means I have gone for a week now without overnight oxygen assistance, which I recognize before you rush to tell me is not really a good idea. Thursday and Friday I woke up at 4:30 a.m. feeling like crap and unable to go back to sleep, and this morning I started at 3:30.
I recognize this is not sustainable, and I am trying to solve the problem, but everywhere I turn seems to run into road blocks, in some cases literally.
Back in 2011 I was diagnosed by an otolaryngologist with sleep apnea, and he prescribed both CPAP and oxygen. Just getting to this diagnosis was convoluted and not aided by me, because in an effort to get seen as fast as possible I switched local medical clinics and it mostly resulted in me supervising my own case.
I never managed to tolerate the CPAP (continuous positive airway pressure), although not for lack of trying. I am quite sure there are those of you out there who will tell me it’s no big deal and really easy to manage, but for every one of you there are two who will agree with me. The medical community estimates CPAP comes with about 40 percent compliance, and of those 40, some large percentage don’t actually wear the mask well.
Certainly the respiratory community is aware of this non-compliancy, because the woman who brought my CPAP and oxygen supplies to the house stressed repeatedly that wearing the oxygen was the more important piece. So I’ve worn the oxygen cannula faithfully while struggling with and giving up on CPAP.
What I discovered early on in this process, along with the part where two companies and multiple face masks never managed to make the process any more tolerable, although it did give me an enduring, panicky sense of claustrophobia, was that medicine in the United States is a huge racket.
Insurance — our vaunted private insurance system that Americans insist they love so much — is a huge player in this. When I went for sinus surgery (a different doctor’s plan to help me breathe better, even though right before I was wheeled into surgery his anesthesiologist assured me I was getting the wrong surgery and that a tonsillectomy would make much more sense), the front desk informed me that my procedure would cost $21,000 — except that due to an agreement with my insurance company they would only charge $2,500.
Not that I had to pay $2,500; no, that was the total charge to the insurance company. That other $18,500 was apparently just thrown out there to see what the market would bear. You have no idea how much this concept, which rages all across our medical system, pisses me off.
Once upon another time I got billed by the University of Colorado for the use of an exam room, and then I got billed by University Physicians for the same use of the same exam room. Indignantly, I called the surprisingly friendly folks at Empire Blue Cross, where they cheerfully assured me that this was standard practice and of course they would pay it. Standard practice to pay two entities the same month’s-worth of rent to be in an exam room for 10 minutes? There isn’t even a way to begin to tell you how wrong this system is.
So when I discovered the first respiratory business here in town was charging my insurance company double what the second respiratory business would, even though my post-insurance cost was the same, it was time to switch. I know there are people who say that’s an insurance company’s problem, not mine, but if you think for an instant that any insurance company is doing something benevolent you are seriously deluded.
Ultimately, of course, that was a bet on the wrong horse, which is what I do all the time, especially when it comes to medical issues. No matter in what good faith I operate, I seem to make decisions that make life harder. Like opting to go with the local company that ended up leaving town.
By then the no-longer local company had sold me a refurbished oxygen concentrator at an end cost of $350, which is what they were billing insurance monthly to rent a unit. Here I insert multiple exclamation points as my only means of conveying my what-the-hell outrage.
By then I also had no one monitoring my case. Doctors came and went; I tried an assortment of specialists without gaining any ground and eventually just rolled with my own supervision. I bought my own recording oximeter for $150, the same price charged for one overnight test by the respiratory company. I hauled my concentrator to Montrose once a year for servicing.
Lynn took it with her just a couple weeks ago, in fact — and then it broke. I called the company, where the woman who answered the phone had no interest in anything I said until I was hanging up, when she wished me the most enthusiastic “Have a great day!” I’ve ever gotten. She didn’t express an ounce of concern that I was without oxygen; she didn’t know if they had any refurbished units for sale — the guy who did might be in later; they maybe could send it out for repair for $250 and it would take four weeks; they no longer send a truck to Gunnison.
I debated calling my physician’s assistant, but here’s how I assumed that would go: she would want to order an overnight oximeter test, and then she would send me to the remaining company in town, the one that was already charging double even when it had local competition.
The software for my oximeter lasted through two computer changes but not three. When Lynn told her rheumatologist — on a telemedicine call that lasts five minutes and costs $500 despite not being able to charge twice for exam room rental (but at least it saves the 10-hour roundtrip travel for pretty much the same five minutes in person) — that she’s been very tired, he suggested sleep apnea as a possibility. I decided it was time to get a new oximeter.
I ordered one on April 26 and the company promptly sent me tracking information the next day. From which I can see that the oximeter is languishing in a Skokie, Ill., post office, awaiting “acceptance.” Aren’t we all?
It has been five days now since some clerk, following his postmaster general’s instructions, no doubt, tossed my oximeter into the dark recesses of the post office, never to be found. I filed a “help” request with the Postal Service, which assures me someone will contact me within one business day, but probably I’m going to have to call the company and suggest they try again, this time with UPS.
In the meantime I located a company in Littleton called “Oxygen Repair.” No one answers the phone there, and when I filled out their online e-mail form, it took me to an “Error 404: Page Not Found,” so I’m not sure how good I feel about this, but when a man did call me back after my first phone call, when I hung up after six rings and no answering machine (no one called back a second time when I let it go to eight rings and finally got an answering machine), he said he was backed up and repair would take three to five — I braced for “weeks,” but he said “days.”
I rushed my concentrator down to Gunnison Shipping to get it out yesterday, and hopefully I will hear back from this company. I suppose if I don’t, they’ve saved me the trouble of disposing of a broken unit, but hopefully they’re more efficient in person than they are with their phone or website.
In the meantime I am running not on oxygen but fumes, which can leave me fuming, particularly about all matters medical and postal.